Provider Demographics
NPI:1659041135
Name:ILERCIL, MORGAN DENIZ (RADT-1)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:DENIZ
Last Name:ILERCIL
Suffix:
Gender:F
Credentials:RADT-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17822 BEACH BLVD STE 278
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17822 BEACH BLVD STE 278
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7180
Practice Address - Country:US
Practice Address - Phone:714-375-3795
Practice Address - Fax:714-375-3796
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1285221217171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty